Hepatitis_0908 - Hepatitis KarenL.OBrien,RN,MSN Spring2011...

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Care of the Patient with  Hepatitis Karen L. O’Brien, RN, MSN Spring 2011
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http://catalog.nucleusinc.com/enlargeexhibit.php?ID=1976&TC=&A=2
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Major Functions of the Liver Metabolic : Carbohydrate metabolism : glycogenesis, glycogenolysis,  gluconeogenesis Protein metabolism : synthesis of amino acids, plasma proteins,  clotting factors, urea from ammonia Fat metabolism : synthesis of lipoprotein, breakdown  triglycerides to FA, formation of ketones, synthesis of FA,  synthesis and breakdown of cholesterol Detoxification : inactivation and breakdown of drugs and  harmful substances, excretion Steroid metabolism : gonadal and adrenal steroid hormones
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Major Functions Bile Synthesis: Production : formation of bile, bile salts, bile pigments  (bilirubin) and cholesterol Excretion : One liter per day!
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Major Functions Storage: Glucose as glycogen Vitamins: Fat soluble (A,D,E,K), water soluble (B1,  B2, cobalamin, folic acid) Fatty Acids Minerals: iron, copper Amino acids: albumin, beta-globulin
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Major Functions Phagocytic  (breakdown) Kupffer cells: Old RBCs WBCs Bacteria Other particles Hemoglobin from RBC to BILIRUBIN
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Viral Hepatitis Inflammation of the liver 5 types of Viral Hepatitis:   A, B C, D, E and G Distinguish by the presence of  antigens   and  antibodies Major public health concern Hepatitis can also be caused by drugs, alcohol,  chemicals
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Pathophysiology Similar for all types Widespread inflammation Acute infection-cause lysis of infected  hepatocytes Liver cell damage leads to NECROSIS Proliferation and enlargement of Kupffner cells  (phagocytic activity) Inflammation can interrupt bile flow
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Viral Hepatitis Symptoms Jaundice Fatigue Abdominal pain Enlarged tender liver Anorexia Nausea Vomiting  Diarrhea Dark urine Light stools Joint pain Or no symptoms at  all
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Viral Hepatitis: Diagnostic Test Antigens and/or antibodies  specific to each type of  virus (see Quick and Dirty) Liver Enzymes : elevated
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